Macular translocation with 360 degree retinotomy for management of age-related macular degeneration with subfoveal choroidal neovascularization

• Published in: American journal of ophthalmology Vol. 134; no. 4; pp. 560 - 565
• Main Authors: Pertile, Grazia, Claes, Carl
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2002; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Eye Diseases - etiology; Eyeglasses; Fovea Centralis - blood supply; Humans; Macula Lutea - surgery; Macular Degeneration - complications; Macular Degeneration - physiopathology; Macular Degeneration - surgery; Medical sciences; Middle Aged; Neovascularization, Pathologic - etiology; Ophthalmologic Surgical Procedures - adverse effects; Reading; Recurrence; Retina - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Treatment Outcome; Vision Disorders - etiology; Vision Disorders - physiopathology; Vision Disorders - rehabilitation; Vision, Ocular; Human; Translocation; Retinopathy; Prognosis; Choroidal neovascularization; Choroid; Maculopathy; Eye; Macular degeneration; Macula; Eye disease; Treatment; Retinotomy; Surgery; Complication; Degeneration; Neovascularization; Technique; Age
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(02)01641-0

PURPOSE: The aim of this study is to evaluate the functional outcome in a group of patients treated with full macular translocation (FMT) with 360-degree retinotomy for treatment of age-related macular degeneration (ARMD) with subfoveal choroidal neovascularization. DESIGN: Consecutive interventional case series. METHODS: Fifty consecutive eyes (50 patients) with ARMD and subfoveal neovascularization who underwent a FMT in our department from January 1999 to July 2000 are included in this study. Compensatory muscle surgery, as described by Eckardt and associates, was performed on all the eyes. The median follow-up is 21 months (range, 12 to 36; SD, 5.4). RESULTS: The best-corrected postoperative visual acuity (BCVA) was improved by 2 or more Snellen lines in 33 eyes (66%) and remained stable (±1 line) in 14 eyes (28%). Only 3 eyes (6%) experienced a deterioration of the BCVA of 2 or more lines. The final BCVA was 20/50 or better in 32% of the cases; only 8 eyes (16%) had a final BCVA < 20/200. Thirty-four (68%) patients are able to read newspaper print (3.3/10) with normal (+3 diopters to +4 diopters) or increased (+5 diopters to +8 diopters) reading ads. Other patients are able to read with magnifying systems. Complications included proliferative vitreoretinopathy (PVR) in 9 eyes (18%), recurrent choroidal neovascularization in 5 eyes (10%), diplopia in 3 eyes (6%), choroidal hemorrhage in 2 eyes (4%), macular hole in 1 eye, and temporary hypotony in 1 eye. CONCLUSIONS: As 68% of the patients in the study group regained reading vision with reading glasses, FMT can be considered an effective approach in cases of subfoveal choroidal neovascularization. Further investigations are necessary to determine which patients will have the most benefit from this complex therapeutic method.